Congenital adrenal hyperplasia classification: Difference between revisions

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! align="center" style="background:#DCDCDC;" rowspan="2" colspan="2" |Disease
! align="center" style="background:#DCDCDC;" rowspan="2" colspan="2" |Disease
! align="center" style="background:#DCDCDC;" colspan="2" |History and symptoms
! align="center" style="background:#DCDCDC;" colspan="2" |History and symptoms
! align="center" style="background:#DCDCDC;" colspan="2" |Laboratory findings
! align="center" style="background:#DCDCDC;" colspan="3" |Laboratory findings
! align="center" style="background:#DCDCDC;" |Defective gene
! align="center" style="background:#DCDCDC;" |Defective gene
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!Blood pressure  
!Blood pressure  
!Genitalia
!Genitalia
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!Increased
!Decreased
!K levels
!K levels
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* Male: normal or scrotal pigmentation and large phallus   
* Male: normal or scrotal pigmentation and large phallus   
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Increased:
* [[Deoxycorticosterone]]
* 17-OHP
* 11-Deoxy-[[cortisol]]
* Progesterone
* [[17-Hydroxyprogesterone|17-hydroxyprogesterone]], mild elevation
* Androstenedione
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* DHEA
* [[Cortisol]]
Decreased:
* [[Corticosterone]]
* Aldosterone
* [[Aldosterone]]
* Corticosterone (salt-wasting)
* Cortisol (simple virilizing)
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|
* High in salt wasting type
* High in salt wasting type
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* Female: virilization after puberty
* Female: virilization after puberty
* Male: normal appearance
* Male: normal appearance
|Increased:
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* 17-OHP
* [[17-Hydroxyprogesterone|17-hydroxyprogesterone]]
* Exaggerated androstene-dione, DHEA, and 17-OHP
* Exaggerated [[Androstenedione]], [[DHEA]], and [[17-Hydroxyprogesterone|17-hydroxyprogesterone]]
response to ACTH
response to [[ACTH]]
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* Normal
* Normal
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* Decreased 17OH-steroids, cortisol, aldosterone, androgens and estrogens
* Decreased 17OH-steroids, cortisol, aldosterone, androgens and estrogens
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* Low
* Low
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* Decreased corticosterone, cortisol,  aldosterone,  androgens
* Decreased corticosterone, cortisol,  aldosterone,  androgens
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* Low
* Low
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* Cortisol
* Cortisol
* Aldosterone
* Aldosterone
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* High
* High
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Revision as of 15:14, 1 August 2017

Congenital adrenal hyperplasia main page

Overview

Classification

21-hydroxylase deficiency
11β-hydroxylase deficiency
17 alpha-hydroxylase deficiency
3 beta-hydroxysteroid dehydrogenase deficiency
Cytochrome P450-oxidoreductase (POR) deficiency (ORD)
Lipoid congenital adrenal hyperplasia

Differential Diagnosis

Classification

Congenital adrenal hyperplasia is classified into seven types based on the genetic causes that lead to hyperplasia and hormonal imbalance.

Disease History and symptoms Laboratory findings Defective gene
Blood pressure Genitalia Increased Decreased K levels
21-hydroxylase deficiency Classic type
  • Low in salt-wasting
  • Normal in non-salt-wasting
  • Female: ambiguous
  • Male: normal or scrotal pigmentation and large phallus
  • High in salt wasting type
  • Normal in non salt wasting
  • CYP21A1 and CYP21A2 gene
Non-classic type
  • Normal
  • Female: virilization after puberty
  • Male: normal appearance

response to ACTH

  • Normal
  • CYP21A1 and CYP21A2 gene
17a-Hydroxylase deficiency
  • Hypertension
  • Female: normal
  • Male: ambiguous
  • Increased DOC, corticosterone
  • Decreased 17OH-steroids, cortisol, aldosterone, androgens and estrogens
  • Low
  • CYP17A1
11β-hydroxylase deficiency
  • Hypertension
  • Female: ambiguous
  • Male: normal or scrotal pigmentation and large phallus
  • Indreased DOC, 11-deoxycortisol
  • Decreased corticosterone, cortisol, aldosterone, androgens
  • Low
  • CYP11B1
3-beta-hydroxysteroid dehydrogenase Increased:
  • DHEA
  • 17-OH pregneno-lone
  • Pregnenolone

Decreased:

  • Cortisol
  • Aldosterone
  • High
Cytochrome P450-oxidoreductase (POR) deficiency (ORD)
Congenital lipoid adrenal hyperplasia
Cholesterol side-chain cleavage enzyme deficiency